How did you first become interested in vaccines?

In late 2016, I was invited to join Afghanistan's National Immunization Technical Advisory Group (NITAG) as an epidemiologist. Later that year, I attended a meeting of the Rotavirus Accelerated Vaccine Introduction Network (RAVIN), where Afghanistan's plans for introducing the rotavirus vaccine were discussed. This meeting included experts from the US CDC, Johns Hopkins, and PATH, and emphasised the importance of analysing pre-vaccine surveillance data and conducting cost-effectiveness analyses.

My role as an epidemiologist prompted me to lead the analysis of surveillance data and receive formal training on the UNIVAC model, developed by my current supervisor, Andrew Clark. Our publications showed the significant burden of rotavirus and the cost-effectiveness of the vaccine, which contributed to Afghanistan introducing the RVV in January 2018. Subsequently, I led the establishment of post-licensure surveillance in four regions of Afghanistan with support from US CDC, WHO Afghanistan, and national hospitals.

Tell us about your current research

I am nearing the completion of my Doctor of Public Health (DrPH) degree, focusing on the post-licensure effectiveness, impact, and safety of the rotavirus vaccine over the past four years.

I recently published a paper on cases of intussusception, a condition affecting bowels, occurring after marketing of the rotavirus vaccine in Afghanistan. Another paper on vaccine effectiveness has been accepted and will be in print next month in the Lancet Global Health. Additionally, I conducted a cost-utility analysis of the rotavirus vaccine using the UNIVAC model, informed by real-world post-licensure surveillance data and ready for journal submission.

What do you find particularly interesting working as a member of the Vaccine Centre?

As a mid-career researcher with over two and a half years of involvement at the Vaccine Centre, I am particularly fascinated by the high level of interaction and knowledge exchange among multidisciplinary collaborators. The Centre fosters professional growth through regular seminars, annual lectures, and monthly meetings. Events organized for World Immunization Week are uniquely engaging, bringing together renowned vaccine scientists, experts, and key players in global immunization like Gavi, the Vaccine Alliance. This blend of scientific discussion and real-world implementation, accessible through open webinars, enriches the experience and extends its reach globally beyond the LSHTM community.

What are some of the real-life implications of your work?

It is beyond words to describe my feeling of not being able to return to my home country, Afghanistan, and contribute to improving the immunization programme due to the current unwelcoming situation for female scientists. Despite this, I am committed to making my research findings accessible to all. I aim to spread the main messages of my findings to parents in Afghanistan, emphasizing that the rotavirus vaccine is safe and effective for their children, and ensuring no doses are missed is crucial. Additionally, the cost-effectiveness analysis reassures the economic benefits associated with RV vaccination, highlighting its health outcome gains. This is a call to the international community: if Afghanistan cannot currently afford to supply childhood antigens, they should step up and ensure Afghan children are not left behind.

What would you consider an interesting fact about yourself and your work

Before I was compelled to leave my country, I worked with UNICEF Afghanistan. I proudly served some of the most deprived children in the world, hoping for a better future for them. The current ban on girls' education in Afghanistan is deeply troubling. As a female scientist, this issue is close to my heart. The restriction on education not only limits opportunities for Afghan girls but also hinders the overall progress of the nation. This motivates me even more to support Afghan children and young women from afar and ensure that the importance of education and healthcare remains in the spotlight.

How can people get and stay in touch with you?

Palwasha.anwari@lshtm.ac.uk or on LinkedIn.